Mandatory Basic Health Insurance (Krankenkasse) — the 90-day enrollment rule
Every person who takes up residence in Switzerland must hold basic health insurance (Grundversicherung / assurance de base) from a Swiss insurer.
The contract, required under the Federal Health Insurance Act (KVG / LAMal), must be in place within three months of the commune residence-registration confirmation. Coverage is back-dated to the date of residence when the deadline is met; if it is missed, the cantonal authority assigns an insurer, coverage starts only from the enrollment date, and a premium surcharge applies unless the delay is justified.
Estimated time
Commune residence registration is required within 14 days of arrival; the basic health-insurance contract must be in place within three months (90 days) of the residence-registration confirmation issue date. Insurers typically issue the insurance certificate within one to four weeks of contract signature.
Cost
CHF0 sign-up fee; monthly premium varies by canton, region, age-band, insurer, and elected deductible
What You Need
Tap to check off items as you gather them
Additional Items
- Premium architecture — four variables determine your monthly premium: canton and region (Geneva and Basel-City at the high end; Appenzell Innerrhoden and Uri at the low end), age-band (child 0–18, young adult 19–25, adult 26+), insurer choice (around fifty authorised insurers; premium variance 20–40 % in the same canton-region-age cell), and elected deductible. Compare on priminfo.ch, the official Federal Office of Public Health portal.
- Deductible tiers for adults (federally fixed under Article 64 of the Federal Health Insurance Act): CHF 300 (standard), 500, 1,000, 1,500, 2,000, 2,500. Child standard CHF 0, with insurers permitted to offer higher tiers. Higher deductibles reduce the premium up to a federal cap of 70 % on the additional risk assumed. The deductible level can only be changed at the start of a calendar year, with written notice by 30 November.
- Coinsurance — above the deductible, a 10 % cost-share (Selbstbehalt / quote-part / partecipazione) applies on insurer payments, capped at CHF 700 per calendar year for adults and CHF 350 for children. Hospitalisation adds a CHF 15 per-day contribution (Spitalbeitrag / forfait journalier / contributo giornaliero) for insured persons aged 25 or over without dependent children.
- 2026 average monthly premiums (announced by the Federal Office of Public Health and the Federal Department of Home Affairs on 23 September 2025; applicable from 1 January 2026): all-bands average CHF 393.30 (+4.4 % year on year); adult CHF 465.30 (+4.1 %); young adult CHF 326.30 (+4.2 %); child CHF 122.50 (+4.9 %). These are national averages — your individual premium depends on canton, region, age, insurer, and elected deductible.
- Premium-reduction subsidy (Prämienverbilligung / réduction de prime / riduzione di premio) — cantonal-administered, jointly financed by federal and cantonal funds. Annual eligibility is based on household taxable income; in households below the cantonal threshold, children receive at least 80 % reduction and young adults in education at least 50 %. Cantonal income thresholds, application windows, and forms vary. Communal involvement is residual and confined to integration with social-assistance casework. In the canton of Zurich, the SVA Zürich administers the subsidy.
- Cantonal premium surcharge formulas — set within federal bounds under Article 5(2) of the Federal Health Insurance Act, which makes a surcharge for unjustified delay mandatory (not discretionary). The Ticino IAS formula is the most concrete numeric reference: 30 % to 50 % of the ordinary premium, for a duration equal to double the registration delay. Other cantons set comparable formulas; the exact percentage and duration vary by canton.
- Cross-border worker right of option — anchored under bilateral agreements between Switzerland and Germany, Austria, France, and Italy. The standardised Choice of health insurance system form must be signed by the home-country statutory insurer (for example, Caisse primaire d'assurance maladie — CPAM — for France) and lodged with the cantonal authority of the canton where you work, within three months of starting work in Switzerland. The option is irrevocable for the duration of the cross-border activity unless personal circumstances change.
- Student exemption — for foreign students, interns, doctoral candidates, and au pairs holding private health insurance equivalent to a Swiss basic-insurance product. Granted for three years and renewable once for a further three years; filed with the cantonal authority within the same three-month window. Any paid work in Switzerland — even small remuneration — triggers the gainful-employment rule and collapses the exemption immediately.
- Cantonal authority delegation to the SVA Zürich — since 1 October 2023, the Sozialversicherungsanstalt des Kantons Zürich is the cantonal authority for compulsory-insurance compliance, exemption applications, and the premium-reduction subsidy in the canton of Zurich; municipalities perform first-line checks. Exemption processing time is approximately five months at current volumes. Federal cost-containment reform context: Cost-Containment Package 2 (Kostendämpfungspaket 2) targets ongoing savings, with further parliamentary debate expected in 2026; reinforced premium-reduction subsidies are phased in from 2026 following the 9 June 2024 popular initiative on health-insurance premiums.
Step-by-Step
- 1
Register with Your Commune within 14 Days of Arrival
Anmeldung / inscription / iscrizione
New Arrival Expat Resident- Book or walk into the residents' registration office (Einwohnerkontrolle / Contrôle des habitants / Controllo degli abitanti) of the commune where you will live, within 14 calendar days of physically arriving in Switzerland and before starting any paid work
- Present your passport or national identity card, residence-permit application or interim communal confirmation, tenancy agreement, and identity documents for accompanying family members
- The commune captures arrival date, canton, address, and family composition, and issues the residence-registration confirmation (Anmeldebestätigung / attestation de domicile / certificato di domicilio) within days
- The issue date printed on the residence-registration confirmation is the canonical start of the 90-day health-insurance countdown — record it
💡 Tip: The 14-day commune-registration window runs from physical arrival. The 90-day health-insurance window runs from the issue date of the residence-registration confirmation. Treat the two deadlines as sequential.
⚠️ Watch out: If you miss the 14-day commune-registration window, register as soon as possible — communal fines and downstream delays apply (permit issuance, banking, school registration, and the health-insurance deadline are all gated on the commune-issued confirmation).
💬 Say:
Ich möchte mich anmelden, ich bin gerade in die Schweiz gezogen.
"I would like to register — I have just moved to Switzerland."
📋 Use when: Greeting at the residents' registration office in a German-speaking canton
💬 Say:
Je voudrais m'inscrire, je viens d'arriver en Suisse.
"I would like to register — I have just arrived in Switzerland."
📋 Use when: Greeting at the residents' registration office in a French-speaking canton
💬 Say:
Vorrei iscrivermi, sono appena arrivato in Svizzera.
"I would like to register — I have just arrived in Switzerland."
📋 Use when: Greeting at the residents' registration office in an Italian-speaking canton
- 2
Compare Insurers and Choose a Basic-Insurance Product within 90 Days
Expat New Arrival Resident- Open priminfo.ch — the Federal Office of Public Health comparison portal — and enter your canton, region, age, and intended deductible
- The basic-insurance benefits catalogue is identical across insurers (set by Articles 24–34 of the Federal Health Insurance Act), so only premium and service-model choices differ
- Choose your deductible tier from the federally fixed adult tiers (CHF 300, 500, 1,000, 1,500, 2,000, 2,500) or, for children, from insurer-available tiers above the CHF 0 standard
- Choose your care model — ordinary free-choice-of-doctor, family-doctor (Hausarztmodell / médecin de famille / medico di famiglia), Health-Maintenance-Organisation (HMO), or telemedicine first-contact (Telmed). Alternative care models reduce the premium without changing the benefits catalogue
- Confirm the insurer is one of the approximately fifty authorised basic-insurance providers — the list is maintained on priminfo.ch
💡 Tip: No insurer can refuse your application, and no health questionnaire or pre-existing-condition exclusion is permitted. Insurer competition operates on price and service, not on risk selection.
- 3
Sign a Contract with Your Chosen Insurer
Versicherungsvertrag / contrat d'assurance / contratto di assicurazione
Expat New Arrival Resident- Apply online through the insurer's website, by post, or in person — provide your passport copy, residence-registration confirmation, residence-permit decision or interim confirmation, AHV number (or placeholder), and IBAN if electing direct debit
- Switzerland does not have single family policies — each spouse and each child requires a separate contract in their own name
- Receive the insurance certificate (Versicherungsausweis / attestation d'assurance / attestato di assicurazione) once the insurer processes the application — typically within one to four weeks
- Cover is back-dated to the residence-registration date when the contract is concluded within the three-month window; premiums are also payable retroactively from that same date
💡 Tip: Cover starts from the date of residence registration — even if you sign on day 80, premiums for the full period since registration are due, and any medical costs from day one are reimbursable.
⚠️ Watch out: If you do not sign within three months, the cantonal authority will affiliate you automatically — see the cantonal-verification step for consequences.
💬 Say:
Ich möchte einen Vertrag für die obligatorische Krankenpflegeversicherung abschliessen.
"I would like to sign a contract for compulsory basic health insurance."
📋 Use when: Phone or counter request to enroll in basic insurance in a German-speaking canton
💬 Say:
Je voudrais souscrire un contrat d'assurance-maladie de base.
"I would like to sign a basic health-insurance contract."
📋 Use when: Phone or counter request to enroll in basic insurance in a French-speaking canton
💬 Say:
Vorrei stipulare un contratto di assicurazione di base.
"I would like to sign a basic-insurance contract."
📋 Use when: Phone or counter request to enroll in basic insurance in an Italian-speaking canton
- 4
Cantonal-Authority Verification and Escalation if the Deadline Is Missed
Expat New Arrival Resident- Cantonal authorities monitor compliance through cantonal procedures — in Geneva the Service de l'assurance-maladie (SAM) opens a file when your commune registration is recorded and writes to you if no proof of affiliation arrives within three months
- In the canton of Zurich, the Sozialversicherungsanstalt des Kantons Zürich (SVA Zürich) has been the cantonal authority for compulsory-insurance compliance since 1 October 2023; municipalities perform first-line checks and refer non-affiliation cases to the SVA Zürich
- In the canton of Ticino, the Istituto delle assicurazioni sociali (IAS) Settore obbligo LAMal supervises the obligation and automatically affiliates non-compliant residents
- If you receive a cantonal letter, respond immediately with proof of an active basic-insurance contract — the letter is a non-compliance warning, not the start of the obligation
- If you do not respond, the cantonal authority will assign you ex officio to a basic-insurance product (typically the lowest-premium offer in the canton-region)
💡 Tip: Cantonal authorities are not the place to enroll — the insurer is. The cantonal authority verifies enrollment and only steps in when you have not enrolled.
⚠️ Watch out: Cantonal-assignment carries three concurrent consequences: (1) the insurer is chosen for you with no negotiation on deductible or care model; (2) coverage starts from the assignment date, so medical costs during the delay are not reimbursed; (3) a premium surcharge applies on top of the ordinary premium, mandatory under Article 5(2) of the Federal Health Insurance Act unless the delay is justified — the Ticino formula sets it at 30 % to 50 % of the ordinary premium for a duration equal to double the registration delay.
- 5
Apply for Premium-Reduction Subsidy or Exemption if Eligible
Resident Expat- Premium-reduction subsidy (Prämienverbilligung / réduction de prime / riduzione di premio) — apply to the cantonal subsidy office. New arrivals without a Swiss tax assessment supply estimated household income from the employment contract and payslips; a provisional decision is reconciled retroactively after the first assessment
- Exemption application — submit to the cantonal authority within the same three-month window. The five categories: diplomats and international-organisation staff; students and trainees with equivalent foreign coverage (granted for three years, renewable once for a further three); cross-border workers exercising the right of option (submit the Choice of health insurance system form counter-signed by the home-country statutory insurer, for example CPAM for France); posted workers under a bilateral social-security agreement; and EU/EFTA pension recipients covered by the pension state
- EU/EFTA pension recipients register the S1 portable document with the Common Institution KVG, which is the federal liaison for cross-border health-cover entitlements
💡 Tip: Exemption processing can take months — the SVA Zürich currently reports approximately five months. Apply early in the three-month window.
⚠️ Watch out: If exemption is declined, enroll in basic insurance immediately. If the decision arrives after the three-month deadline, ask the cantonal authority whether the application itself stops the surcharge clock — practice varies by canton.
- 6
Manage the Annual Cycle — Premium Review and Insurer Change
Resident- Each October your insurer notifies you of the new-year premium and deductible offer. Check whether premiums in your canton-region have moved relative to other insurers — variance in the same canton-region-age cell is typically 20–40 %
- To change insurer or deductible, send written cancellation notice to your current insurer by 30 November for the change to take effect on 1 January (Article 7 of the Federal Health Insurance Act)
- A shorter one-month cancellation window applies after the annual premium-change notification — use this route to switch in response to the new-year increase
- Apply for the premium-reduction subsidy annually — cantonal subsidy offices distribute application forms in early summer for the following year
💡 Tip: Basic insurance and supplementary insurance are separate. The 30 November deadline applies only to basic insurance. Supplementary insurance (Zusatzversicherung / assurance complémentaire / assicurazione complementare) is governed by the Federal Insurance Contract Act.
⚠️ Watch out: If you miss the 30 November deadline, you remain with the current insurer and current deductible for the following calendar year. The October new-premium-notification window may provide a second chance.
Local Tips from the Community
- The 90-day deadline starts on the issue date of your residence-registration confirmation, not on the date you arrived in Switzerland. Photograph the confirmation on the day you receive it — that date is your countdown anchor.
- You can sign an insurance contract before your commune registration is complete. Insurers accept pre-arrival enrollment and back-date the cover to your actual residence date once the registration confirmation is supplied.
- Compare premiums on priminfo.ch for your exact canton, region, age, and chosen deductible. Because the benefits catalogue is federally fixed, the cheapest basic-insurance product covers the same medical care as the most expensive.
- Do not wait for the cantonal authority's letter before signing a contract. By the time the letter arrives, the 90-day window has already lapsed and the cantonal-assignment regime applies.
- If you receive medical care before your insurer card arrives, pay the bill yourself and submit it to your insurer for reimbursement once the contract is active. Cover is effective from the contract start date, regardless of when the physical card is mailed.
Costs
| Item | Amount | Payment | Notes |
|---|---|---|---|
| Basic-insurance sign-up fee | CHF0 | N/A | Insurers cannot charge a sign-up fee, administrative fee, or risk-loading for basic insurance under the Federal Health Insurance Act. Monthly premiums vary by canton, region, age-band, insurer, and elected deductible — compare on priminfo.ch for your individual quote. |
- Payment:
- N/A
- Notes:
- Insurers cannot charge a sign-up fee, administrative fee, or risk-loading for basic insurance under the Federal Health Insurance Act. Monthly premiums vary by canton, region, age-band, insurer, and elected deductible — compare on priminfo.ch for your individual quote.
FAQ
General
When does the 90-day clock start exactly?
On the issue date of the commune residence-registration confirmation (Anmeldebestätigung / attestation de domicile / certificato di domicilio). Cantonal authorities anchor the three-month period to taking up residence (Wohnsitznahme / prise de domicile / presa di domicilio) as recorded by the commune. Your arrival date in Switzerland is relevant for the 14-day commune-registration deadline but not for the 90-day insurance clock.
Can I shop around for the cheapest insurer?
Yes. Use priminfo.ch to compare premiums for your canton, region, age, and elected deductible. The benefits catalogue is identical across insurers (federally fixed under Articles 24–34 of the Federal Health Insurance Act), so the cheapest basic-insurance product covers exactly the same medical care as the most expensive.
Can I take out only emergency or minimum cover?
No. Basic insurance is a single product with a federally defined scope. Your legal choices are limited to insurer, deductible level, and care model (ordinary, family doctor, Health-Maintenance-Organisation, or telemedicine). There is no minimum or emergency-only variant. An EU European Health Insurance Card and any private travel or expat-international policy do not exempt you from basic-insurance affiliation as a resident.
I missed the 90-day deadline. What happens?
The cantonal authority will affiliate you to a basic-insurance product automatically, typically the lowest-premium offer in the canton-region. Coverage starts only from the affiliation date — medical costs incurred during the delay are not reimbursed — and you remain liable for premiums from your residence-registration date. A premium surcharge applies on top of the ordinary premium unless the delay is justified, mandatory under Article 5(2) of the Federal Health Insurance Act. The Ticino formula is the most concrete example: 30 % to 50 % of the ordinary premium for a duration equal to double the registration delay; other cantons use comparable formulas.
I am a cross-border worker living in France. Do I have to take out Swiss insurance?
You are in principle subject to Swiss basic-insurance affiliation, but you may exercise the right of option (Wahlrecht / droit d'option) within three months of starting work in Switzerland to remain in the French statutory health system. Submit the standardised Choice of health insurance system form, signed by the Caisse primaire d'assurance maladie (CPAM), to the cantonal authority of the canton where you work. The option is irrevocable for the duration of the cross-border activity unless your personal circumstances change. Equivalent procedures apply to cross-border workers resident in Germany, Austria, and Italy.
I am a student from outside the EU/EFTA. Do I have to take out Swiss insurance?
You are subject to basic-insurance affiliation by default, but you may apply for exemption if you hold private health insurance offering coverage equivalent to a Swiss basic-insurance product. The exemption is granted for three years and is renewable once for a further three years. File the application with the cantonal authority of the canton where you study within three months of taking up residence. Any paid work in Switzerland — even small remuneration — triggers the gainful-employment rule and collapses the exemption immediately, with a fresh three-month window opening from the start-of-work date.
My household income is low. Can I get help with the premium?
Yes — apply for the cantonal premium-reduction subsidy (Prämienverbilligung / réduction de prime / riduzione di premio). The subsidy is cantonal-administered and jointly financed by federal and cantonal funds; communal involvement is residual and confined to integration with social-assistance casework. Cantonal income thresholds and procedural details vary. In households below the threshold, children receive at least 80 % premium reduction and young adults in education at least 50 %. In the canton of Zurich, the cantonal social-insurance authority (SVA Zürich) administers the subsidy.
Does the European Health Insurance Card (EHIC) or my private travel insurance exempt me from Swiss basic insurance?
No. An EHIC issued by another EU member state covers emergency or unforeseen care during temporary stays but does not satisfy Swiss residence-based affiliation. Likewise, private travel or expat-international insurance from a non-Swiss insurer does not exempt you from basic-insurance affiliation as a resident. A new resident in Switzerland who relies on an EHIC or a private international policy and misses the three-month deadline is exposed to retroactive premiums, no-retroactive-cover for medical costs during the delay, and the cantonal premium surcharge.
Can I cancel my contract mid-year?
Not for ordinary reasons. The ordinary cancellation deadline under Article 7 of the Federal Health Insurance Act is 30 November for a 1 January change. A shorter one-month window applies after the annual premium-change notification (typically issued in October). Other exceptional rights are insurer-specific.
What about my children?
Each child requires a separate contract in their own name, concluded by a parent. The standard child deductible is CHF 0, with higher tiers at the insurer's discretion. The 10 % cost-share above the deductible is capped at CHF 350 per calendar year for children. A child born in Switzerland is automatically deemed insured for the first 90 days from birth, after which a contract must be in place.
After This Process
- → If you are also processing a residence permit, read the Swiss residence-permits guide — the commune residence-registration step is the shared upstream gate for both procedures
- → If your employment or pension situation triggers the Swiss source-tax regime (Quellensteuer / impôt à la source), check the Swiss source-tax guide for the cantonal tariff applicable to your canton of residence
- → Within one month of contract signature, register your insurer card details with your primary-care doctor and pharmacy of choice
- → If your household income is low or your circumstances change mid-year, file a premium-reduction subsidy application with the cantonal subsidy office
Sources
- Federal Office of Public Health — Health insurance landing (bag.admin.ch ↗)
- Common Institution KVG — Versicherungspflicht (kvg.org ↗)
- République et Canton de Genève — Affiliation obligatoire (ge.ch ↗)
- SVA Zürich — Compulsory health insurance (svazurich.ch ↗)
- Repubblica e Cantone Ticino IAS — LAMal (www4.ti.ch ↗)
- priminfo.ch — official premium-comparison portal (priminfo.ch ↗)
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10 sources cited last accessed 2026-05-18
T1 official portal · T2 embassy/consulate · T3 news · T4 community — higher tier wins on conflict. methodology →
- T1Federal Office of Public Health (BAG / OFSP / UFSP / FOPH) — Health insurance: Requirement to obtain insurance for persons resident in Switzerland 2026-05-18
Anyone settling in Switzerland must take out health insurance within three months after taking up residence or being born in Switzerland. Health insurers are obliged to enrol all applicants without exclusions or waiting periods. If insurance is obtained within the specified period, coverage takes effect from the beginning of residence and any costs incurred since the starting date are reimbursed retrospectively. In the event of delayed registration, coverage only takes effect from the date of enrolment and a surcharge is payable unless the delay is justified.
bag.admin.ch - T1Federal Office of Public Health (BAG / OFSP / UFSP / FOPH) — Health insurance landing 2026-05-18
Insurers offering compulsory health insurance are supervised by the Federal Office of Public Health. Basic insurance offers the same range of benefits to all insureds, ensuring high-quality and comprehensive basic care for all. Supplementary insurance is voluntary and covers additional comforts such as a semi-private or private ward in hospital or services not covered by basic insurance.
bag.admin.ch - T1Federal Office of Public Health (BAG) — Optional deductibles 2026-05-18
The standard deductible is CHF 300 for adults and CHF 0 for children. Adult policyholders may choose one of six tiers: CHF 300, 500, 1,000, 1,500, 2,000, 2,500. A maximum of 70 percent reduction on the additional risk assumed may be granted. A change to the deductible level can only take effect at the beginning of a calendar year.
bag.admin.ch - T1Federal Office of Public Health (BAG) — Cross-border commuters working in Switzerland 2026-05-18
Switzerland has bilateral agreements with Germany, Austria, France, and Italy under which EU-citizen residents of these countries have the option of taking out health insurance in their country of residence. French-resident commuters must, within three months, complete the Choice of health insurance system form and return it, signed by CPAM, to the cantonal authority of the canton where they work.
bag.admin.ch - T1Federal Office of Public Health (BAG) — Health insurance: Foreign students in Switzerland 2026-05-18
Students from countries outside the EU/EFTA can apply for exemption from Swiss compulsory health insurance if they hold private health insurance offering equivalent coverage. The exemption is granted for three years and may be renewed for a further three years.
bag.admin.ch - T1Common Institution KVG (Gemeinsame Einrichtung KVG / Istituzione comune LAMal) — Versicherungspflicht 2026-05-18
Every person resident in Switzerland must take out health insurance, or be insured by their legal representative, within three months of taking up residence or being born in Switzerland. Verification of the insurance obligation is regulated cantonally. The Common Institution KVG is the federal statutory body for international coordination of basic insurance, the risk-equalisation fund among insurers, and delegated cantonal supervision for nine cantons and three municipalities.
kvg.org - T1République et Canton de Genève — Service de l'assurance-maladie (SAM): Affiliation obligatoire 2026-05-18
Affiliation must be effective within the three months following the taking up of residence in Geneva. If the SAM receives no proof of affiliation within three months, it writes to the resident requiring action; failing a response, the resident is automatically affiliated to an insurer (affiliation d'office).
ge.ch - T1SVA Zürich — Compulsory health insurance: Application 2026-05-18
The SVA Zürich has been responsible for applications for exemption from compulsory health insurance since 1 October 2023. Municipalities examine compliance for persons who have settled there or established residence, and assign persons without coverage to a health insurer.
svazurich.ch - T1Repubblica e Cantone Ticino — IAS Settore obbligo LAMal 2026-05-18
Registration with a recognised health insurance provider must be completed within three months from registration with the competent population control office. A resident who registers late must pay a premium supplement set by the insurer based on financial situation, between 30 % and 50 % of the premium, for a period equal to twice the length of the registration delay.
www4.ti.ch - T1Canton of Zurich (zh.ch) — Premium reduction for compulsory health insurance 2026-05-18
Insured persons in modest economic circumstances are supported with a contribution to the premiums for compulsory health insurance. The premium-reduction subsidy in the canton of Zurich is implemented by the cantonal social-insurance authority (SVA Zürich).
zh.ch